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10 Consult Coding Tips for 2010
No doubt about it. One of the biggest coding challenges in 2010 will be how to code consults - or what used to be consults. Hospital inpatient visits will be especially tricky.
But don't worry. My Coding Career has consulted the experts to gather these 10 best practices for consult coding in 2010.
The background: Medicare has scrapped consultation codes, and in 2010 will no longer accept codes from CPT's 99241-99255 section. So, when you're billing Medicare, you'll have to find other codes to describe what used to be consults. Meanwhile, some non-Medicare payers will continue to accept consultation codes.
Here are 10 steps you can take to get paid and stay compliant:
1. Expect some larger payers to ditch consult codes as well. Some larger private payers (such as Blue Cross Blue Shield, Aetna, and Humana) will follow Medicare's lead and won't accept consult codes in 2010, experts predict.
2. Check with your payers. Some payers will continue to accept consult codes. Payers will announce their consult code policies by mid-December.
Tip for executing #1 & #2: Keep a spreadsheet to track each of your payers' 2010 consult code policies, and be sure to document their instructions.
Next, what about Medicaid?
3. If you bill Medicaid, check with your state for consult instructions. Just because Medicare isn't accepting consult codes doesn't mean things are the same for Medicaid across the board.
4. If two or more physicians see a patient during a hospital stay, make double-sure the ICD-9 codes and/or the physician notes justify the need for two or more physicians to see the patient.
5. Stop thinking of CPT 99221-99223 as ‘admit codes.' When a physician consults a patient on his first day in the hospital, you should use an initial hospital code. More than one physician can use an initial hospital care code for the same patient, as long as you keep #4 in mind.
6. Meet modifier ‘AN.' When billing Medicare, modifier ‘AN' designates a doctor as the admitting physician. If no one uses the modifier, the claim will be subject to medical review, experts predict.
7. Look at time when choosing codes for hospital inpatient care you're billing to Medicare. At the higher levels, consults' transfer to hospital care codes will benefit your practice's bottom line. For 99244 and 99245, you would gain approximately 30 percent in pay if you also report the prolonged services.
8. Expect reimbursement to be lower for lower-level hospital inpatient visits that would have been consults under Medicare's old system.
9. Focus on total work when coding for split/shared inpatient visits for Medicare. You can ignore one requirement here thanks to Medicare's invalidation of the consult codes. Even if the physician does not duplicate the key components that the nonphysician practitioner (NPP) performed, you can count all medically necessary history, examination, and medical decision making that the and physician each individual performs and documents on a calendar day.
10. Apply your new/established patient rules when coding visits that would have been consults under Medicare's old rules. For example, say an internist sends a patient to a cardiologist for an opinion, and that patient saw that cardiologist two years before. The cardiology practice should choose from the ‘established' patient codes to bill the visit.
10 Solid Reasons To Make Your Next PC A Notebook
Notebook computers are becoming very popular. They seem to be popping up everywhere: on tv shows, on airplanes, in movies, or in your friend's lap. These sleek little machines are invading our daily lives like never before... and the invasion has just started. Find out why they have become so popular with their users and why your next PC should probably be a notebook computer.
It is estimated that over 42 million computer notebooks will be produced this year. And that number is said to be growing by 20% each year. So what's driving the demand for these devices, what's making them so popular?
It's more than just the next tehno fad, notebook computers offer some very practical solutions to our computing requirements and needs. There are some real solid reasons why they have become so popular among their users. These are the same reasons why you should consider making your next PC purchase a notebook or laptop computer.
So if you need convincing, here are those 10 solid reasons why you should consider buying a notebook computer:
1. Size. This is one situation where size really does matter. It's the main reason you should consider buying a notebook or laptop in the first place. You want a PC that will fit neatly in your hand to take to your next office meeting, you want a convenient laptop to take to class or you want a notebook for your next cross country business trip.
Notebooks come in a variety of sizes to match your needs or purpose. They are categorized or grouped accordingly:
Tablet PC (smallest) Size of a paper tablet or notepad, less than 3 pounds.
Utra Portable (small), around 11' x 10', less than 1.3 inches thick, less than 4 pounds.
Thin and Light (mid-size), around 11-14' x 11', 1 to 1.4 inches thick, from 5 to 7 pounds.
Desktop Replacements (largest), more than 13' x 11', more than 1.5 inches, more than 7 pounds and up.
As you can see there is a great range of sizes so you should have no trouble finding a notebook computer to satisfy your needs. Just match the notebook size to the main purpose or use of your notebook and you can't go wrong.
2. Portability. Probably the second, if not the most important reason you're considering buying a notebook or laptop. You want a PC that's portable and lightweight. One that you can take anywhere; to class, to meetings, on business trips or from room to room in your home.
This freedom of movement -- taking your office or vital data along on your business or personal travels is the main selling point of the notebook computer. The portability factor is one you should seriously consider -- do you need a portable computer for your home, work or just for pure enjoyment.
3. Performance. Not too long ago, notebooks or laptops were viewed by many as second class computers when compared to the performance and speed of the mighty desktop PC. Distance cousins discreetly allocated to the sidelines.
But things have changed! Although still not on par with the desktop, thanks to the next generation notebook chipset, Intel's New Sonoma Platform, many notebooks come very close to providing the performance level of a desktop PC. Many notebooks, especially the desktop replacements, already have impressive technical specs that would shame most ordinary desktops. Some of these desktop replacements even use desktop processors or CPU's.
With hard drives up to 100GB or more at (7,200rpm), with RAM up to 2MB in some cases, and supported with Intel Pentium 4's, at 3.4GHz or more --- most notebooks are very capable of handling almost all computing applications and functions with ease. They can do the job.
4. Connections. We live in a wireless world. The notebook will do for computers, what the cell phone did for the telephone industry -- make our communications wireless. Being constantly connected to your friends, your business or your family does have a certain appeal that can't be denied. The notebook computer will give you this wireless connection.
Most notebooks now come with WI-FI (Wireless Fidelity), also known as 802.11 a/b/g, with the ability to stay connected no matter where you are. As more and more businesses such as hotels, restaurants, and airports offer these 'hot spots' or WI-FI service to their patrons, easy connections will become commonplace.
5. Function. There are certain functions that are unique to the notebook computer. The tablet PC provides a convenient device for note taking and data gathering that's not practical on a desktop computer. For business professionals such as doctors, lawyers, real estate agents...these tablet notebooks do very practical 'in-the-field' chores or tasks. Other notebooks are very useful for powerpoint presentations at meetings and other gatherings.
6. Backup. The notebook or laptop can be used as a convenient backup of your vital files and programs. Often overlooked, but the notebook can provide a rather cheap and safe way to protect your sensitive data. Anyone who has had a major or total loss of their hard drives can appreciate the importance of having a safe backup system.
For those constantly surfing the net, exposing your sensitive data to all the hazards (viruses, worms, spyware, etc.) can lead to problems. Having a separate system stored on a laptop or notebook can be a good way of working around this problem.
7. Variety. Notebooks and laptops offer much more variety than the ordinary desktop PC. From a small pocket size tablet PC all the way up to a Multi-Media desktop replacement that offers TV, Stereo, CD/DVD Player, as well as a computer of course.
There is a greater range of systems to choose from; all the way from sleek custom designed notebooks to huge monster gaming laptops, there's something to satisfy most tastes. You can also buy a notebook to match your style; from IBM black to Ferrari Red. It's out there.
8. Price and Availability. Notebooks are everywhere and they're getting cheaper by the minute. Notebook prices are coming down, as more and more notebooks are sold -- the price will drop even more. They're still slightly more expensive than a desktop PC but the gap is closing fast.
Finding a seller or dealer is very easy, shopping online directly from the manufacturer or company is also becoming very popular. In addition, there are also some very good reputable online dealers that's spreading the notebook gospel. Your dream notebook is only a click away.
9.Sex Appeal. It has to be mentioned, notebook computers are sexy! There's no denying it; these sleek, svelte machine are some of the sexiest accessories this side of a Batwatch Extra. The notebook's great looks will probably be the first drawing card for many people who's considering buying a notebook. A fully functional accessory that will not only turn heads but can also do the books.
10. Last but not least, the main reason you should consider buying a notebook computer -- because you want one. Just for the convenience, portability, or the downright pleasure of owning a notebook computer. Besides, it's a proven medical fact that denying your wants or needs can be detrimental to your health.
Go treat yourself!
For More Information on Buying Computer Notebooks and Laptops Click Here:Computer Notebook Buyer's Guide. Copyright © 2005 Titus Hoskins of http://www.bizwaremagic.com This article may be freely distributed if this resource box stays attached.
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